Making it LeanMaking it LeanShands AGH Core Lab Process Shands AGH Core Lab Process
Improvement and Layout RedesignImprovement and Layout Redesign
Mary Hageman and Lauren MilneShands HealthCare
OutlineOutline
• Introduction• Biographical Information• Problem Formulation• Objectives• Methodology• Recommendations• Financial Impact• Conclusion
Biographical InformationBiographical Information
Mary Hageman•University of Florida graduate•Magna Cum Laude in Dec 2005 with BS in Industrial and Systems Engineering•Starts as full-time engineer at MECS in February
Lauren Milne•University of Florida student•Industrial and Systems Engineering with minor in business•Plans to graduate May 2008•Intern at MECS since May 2005
IntroductionIntroductionWho Are We?Who Are We?
• Shands AGH• Ayers Medical Plaza• Rocky Point (located off-site)• Core Lab (located within Shands
AGH)• External Consulting Group
Benchmark
IntroductionIntroductionCurrent StateCurrent State
Hematology
Front Desk
Chemistry
Phlebotomy
Specimens arrive from patient rooms or the Emergency Room by
Phlebotomists
Specimens arrive from outpatient clinics
IntroductionIntroductionCurrent StateCurrent State
Hematology
Front Desk
Chemistry
Phlebotomy
Specimens accessioned and transported to appropriate testing
area
IntroductionIntroductionCurrent StateCurrent State
Hematology
Front Desk
Chemistry
Phlebotomy
Specimens advance through testingprocedures
IntroductionIntroductionCurrent StateCurrent State
Hematology
Chemistry
Problem FormulationProblem FormulationExternal Consulting Group
Implemented Staff Reductions
Need for Improvements Noted
Demand for Change in Staffing Levels and Increase Satisfaction
Project ObjectivesProject Objectives
• Identify process improvement opportunities to increase lab efficiency.
• Determine required staffing levels based on peak workload analysis.
• Design improved layout.• Quantify financial impact.
MethodologyMethodology
• SWOT Analysis• Lean Concepts• Systematic Layout Planning• Workload Analysis
MethodologyMethodologySWOT AnalysisSWOT Analysis
Top 5 Findings 1. Limited staff during busy times2. Split Chemistry and Hematology
departments3. Lack of effective communication4. Multiple processing areas5. Lack of cross-training
MethodologyMethodologyLean ConceptsLean Concepts
Transport
Overproducing
Waiting Over processing
Inventory
Motion
Defects orCorrection
SevenDeadly Wastes
MethodologyMethodologyLean ConceptsLean Concepts
The 7 Deadly Wastes Found and Eliminated
Short-Term•Inventory•Transport•Waiting•Motion
Long-Term•Over processing•Inventory•Transport•Waiting•Motion
Lean ConceptsLean ConceptsMotionMotion
103.42 Feet of Travel 85.44 Feet of Travel
Current Proposed
Total Savings: 17.98 Feet of Travel
MethodologyMethodologySystematic Layout PlanningSystematic Layout Planning
• Flowcharts– Front Desk– Hematology– Chemistry: Primary Tests– Chemistry: Other Tests
• Relationship Diagram • Proposed short-term and long-term
layouts
MethodologyMethodologySystematic Layout PlanningSystematic Layout Planning
• Relationship Diagram
MethodologyMethodologyWorkload AnalysisWorkload Analysis
Benchmark vs. Actual FTEs
0
5
10
15
0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23
Time of Day
FTEs
Actual FTEs Benchmark FTEs
• Add extra supply location for Test 7• Continue storing pre-made controls in
freezer• Relocate label printer• Move incubator to storage• Relocate heat block• Standardize receiving window layout• Purchase new head for cytospin
Recommendations Recommendations ShortShort--termterm
Move to a more central location
Recommendations Recommendations Relocate Heat BlockRelocate Heat Block
Recommendations Recommendations Receiving WindowReceiving Window
Interviewed Lab Technicians to see which equipment was used most often
Recommendations Recommendations Receiving WindowReceiving Window
Recommendations Recommendations Purchase New HeadPurchase New Head
Recommendation: Replace old cytospin
with new head for testing machine
Impact: Reduced walking time, maintenance costs and
space
ShortShort--term Impactterm Impact
• Examples of lean waste reduction:– Transport– Motion– Waiting– Inventory
• Maintenance cost savings• Better space allocation• Reduction of travel time by 62 hours
annually
RecommendationsRecommendationsLongLong--termterm
• Layout redesign• Purchase stacked printer stands• Relocate triage meter• Fill vacant position with swing shift
11 am to 7:30 pm• Spread out phlebotomy draws
between 1 am and 5 am to even workload
• Combine Chemistry and Hematology departments
• Relocate Phlebotomy behind front desk• Create break room • Create office for Assistant Lab
Supervisor• Provide centralized storage• Keep Hematology close to Blood Bank
RecommendationsRecommendationsLayout RedesignLayout Redesign
LongLong--term Impactterm Impact• Example of lean waste reduction:
– Transport– Motion– Waiting– Over processing– Inventory
• Improve lab and front desk coverage• Improve space allocation• Improve communication• Reduction of travel time by 478 hours annually
Financial ImpactFinancial ImpactShortShort--termterm
Financial ImpactFinancial ImpactLongLong--termterm
Financial ImpactFinancial ImpactLongLong--termterm
Financial ImpactFinancial ImpactOverallOverall
ConclusionConclusion
• All short-term recommendations have been implemented.
• Communication within the Core Lab has increased.
• Implementation of long-term layout changes will continue after executive approval.